型肝炎病毒感染的分子诊断:系统性审查
1Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington and Harborview Medical Center, Seattle 98104-2499 , USA.
JAMA
|February 22, 2007
概括
核酸测试证实了C型肝炎病毒 (HCV) 感染,并指导治疗. 在治疗期间监测HCVRNA水平可以预测治疗成功,并决定是否继续或停止抗病毒药物治疗.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 病毒学 病毒学
- 分子诊断学 分子诊断
背景情况:
- 肝炎C病毒 (HCV) 是一个重要的血液传染病原体.
- 核酸检测 (NAT) 对于HCV诊断,预后和治疗监测至关重要.
- NAT提供了指导抗病毒治疗和评估治疗反应的基本信息.
研究的目的:
- 审查目前对HCV的分子诊断测试.
- 讨论这些测试的临床应用.
- 探索分子诊断如何为HCV的自然史提供信息.
主要方法:
- 关于 MEDLINE 的综合文献搜索,参考清单和会议摘要 (1966-2006).
- 根据HCV分子诊断的临床相关性选择研究.
- 审查的重点是HCV测试的诊断,应用和预后价值.
主要成果:
- 定性NAT证实HCV感染,并选低检测限度的献血.
- 肝炎病毒基因型检测为治疗选择提供信息,并预测治疗反应.
- 在治疗期间对HCVRNA进行定量监测可以预测持续的病毒学反应 (SVR).
- 快速病毒学反应 (RVR) 和早期病毒学反应 (EVR) 是治疗成功的强有力的预测指标.
结论:
- 敏感的NAT对于确认急性和慢性HCV感染至关重要.
- 治疗前的基因型和定量HCVRNA测试有助于治疗选择和反应评估.
- 在治疗期间监测HCVRNA对于预测SVR至关重要.
- 建议在整个治疗过程中始终使用相同的定量HCVRNA测定.
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